Transcription of SHIPPER PLEASE NOTE SHIPPER PLEASE NOTE …
1 & FREIGHT CHARGES ARE PREPAID UNLESS MARKED COLLECT STRAIGHT bill OF lading SHORT FORM - ORIGINAL - NOT NEGOTIABLE SHIP DATE: _____ SHIPPER NO: _____ REF / NO: _____ Chino, CA (909) 591-1737 or (800) 382-7438, Manteca, CA (209) 823-0071 or (800) 762-3957, Pixley, CA (800) 229-1737, Phoenix, AZ (602) 257-8381 or (800) 229-1737 Fax (909) 590-4606 Fax (209) 823-2612 Fax (559) 757-8030 Fax (602) 257-8391 COD AMOUNT $ COD WILL REMIT TO SHIPPERS ADDRESS UNLESS THIRD PARTY INFORMATION IS COMPLETED PLEASE REMIT COD TO THIRD PARTY _____ ADDRESS _____ CITY/ST/ZIP CHARGES ARE PREPAID UNLESS MARKED COLLECT CHECK BOX IF COLLECT FOR FREIGHT COLLECT SHIPMENTS: If this shipment is to be delivered to the consignee, without recourse on the consignor, the consignor shall sign the following statement.
2 The carrier may decline to make delivery of this shipment without payment of freight and all other lawful charges SHIPPER Signature FREIGHT CHARGES ARE PREPAID UNLESS MARKED COLLECT CHECK BOX IF COLLECT Number of Packages Type of Packaging (Dr, Bx, Pail) HM Description of Articles, Special Marks and Exceptions Weight (Subject to Correction) Class (Subject to Correction) Lbs. Lbs. Lbs. Lbs. Lbs. Lbs. SHIPPER CERTIFICATION CARRIER CERTIFICATION & RECEIPT This is to certify that the above named materials are properly classified, described, packaged, marked, labeled, and are in proper condition for transportation according to the applicable regulations of the Department of Transportation.
3 Signature Date Company Carrier acknowledges receipt of packages and required placards. Carrier certifies emergency response information was made available and/or carrier has the Department of Transportation Emergency Response Guidebook or equivalent document in the vehicle. Signature Date Lee Jennings Target Express, Inc. Number of Pieces Mark with an X or RQ to designate HAZARDOUS MATERIALS as defined in Department of Transportation Regulations. LEE JENNINGS TARGET EXPRESS, INC.
4 (CARRIER) LIABILITY: Shipments valued at more than $ per pound are of extraordinary value. The carrier s maximum liability is $ per pound, subject to $100,000 total liability, unless the SHIPPER declares excess value on the bill Of lading , pays an additional charge determined by carrier and displays the quote number issued by carrier on the bill Of lading . RECEIVED, subject to individually determined rates and contracts that have been agreed upon in writing between the carrier and the SHIPPER , if applicable, otherwise to the rates, classifications and rules that have been established by the carrier and are available to the SHIPPER upon request; THE PROPERTY DESCRIBED ABOVE, in apparent good order, except as noted (contents and condition of contents unknown) marked, consigned, and destined as shown above, which said carrier agrees to carry to destination, if on its route, or otherwise to deliver to another carrier on the route to destination.
5 Every service to be performed hereunder shall be subject to all the conditions not prohibited by law, whether printed or written, or herein contained, which are hereby agreed to by the SHIPPER and accepted for himself and his assigns. LJTE BOL 05092011 SHIPPER _____ ADDRESS _____ CITY/ST/ZIP PREPAID INVOICES WILL BE SENT TO THE SHIPPERS ADDRESS UNLESS THIRD PARTYINFORMATION IS COMPLETED OR FREIGHT CHARGES ARE MARKED COLLECT bill TO THIRD PARTY _____ ADDRESS _____ CITY/ST/ZIP CONSIGNEE _____PHONE _____ NUMBER _____ ADDRESS _____ CHECK BOX IF THE CONSIGNEE REQUIRES A DELIVERY APPOINTMENT
6 CITY/ST/ZIP CHECK BOX IF THE DELIVERY ADDRESS IS A RESIDENTIAL ADDRESS CARRIER PRO NUMBER Corporate / Terminal 1465 E. Franklin Ave. Pomona, CA 91766 (909) 868-1040 SCAC Code JLEI SHIPPER PLEASE NOTE SHIPPER PLEASE NOTE